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OBSERVATIONS 



BILIOUS DISEASES, 



FROM THE WORKS OF THE ABLEST MEMBERS 
OF THE MEDICAL PROFESSION, 

WITH REMARKS ON THE EXTRAORDINARY VIRTUES OP 

DEVOTION'S LEXIPYRETA, 



IN THE TREATMENT AND CURE OF 



FEVER AND AGUE, 



CHILL FEVER, 
INTERMITTENT AND REMITTENT 
FEVERS, DUMB AGUE, JAUNDICE, 
LIVER COMPLAINT, ENLARGEMENT OF THE SPLEEN 
AND LIVER, AND ALL THE VARIOUS FORMS 
OF BILIOUS DISEASES INCIDENT 
TO THE SOUTHERN AND 
WESTERN STATES. 



BY JOHN L. DEVOTION. 



NEW YORK 
1852. 




Entered, according to Act of Congress, in the year One Thousand Eight Hundred and Fifty two, 
BY JOHN L. DEVOTION, 
In the Clerk's Office of the District Court of the United States for the 
Southern District of New York. 







DEYOTIOFS LEXIPYRETA, 



FOR THE PREVENTION AND CURE OF 



FEVEE AND AGUE, 

CHILL FEVER, DUMB AGUE, INTERMITTENT AND REMITTENT 
FEVERS, AND ALL THE VARIOUS FORMS OF 
BILIOUS DISEASES. 



The unparalleled, and very flattering success which the Lexipyreta has met 
with, in the treatment and cure of Fever and Ague, since its first introduction 
[in the year 1848,] justly entitles it to public confidence, and gives it a pre- 
eminence over every other remedy for bilious diseases. 

It has often been observed that, in certain regions of country where abun- 
dant vegetable decomposition accompanies an occasional overflow of the soil, 
and at the season when this decomposition is most rife, a class of diseases is 
apt to prevail, entirely distinct from those which arise from irregularities, or 
changes in the sensible qualities of the atmosphere. This result has been 
usually ascribed to aeriform exhalations, which have received the name of 
marsh miasmata or malaria, because they are notoriously common in marshy 
places. These diseases are peculiar to certain localities in England, France, 
Holland, Italy, Spain, India, the United States, and other parts of the world, 
and are known under the name of Intermittent Fever, or Fever and Ague, — 
Remittent Fever — Dumb Ague — Chill Fever — Bilious Fever — Headache — 
Tic-Doloureux, &c. 

The circumstances which appear to be essential to the production of malaria 
are heat, moisture, and vegetable decomposition. The peculiar morbid effects 
ascribed to this cause, and by which alone its existence can be recognized, 
seldom originate at a temperature under 60° F., even though vegetable 
decomposition may be going on. At 80° they are very prevalent, and are 
generally checked by the occurrence of frost. A certain continuance of the 
heat is not less necessary than a certain degree of it. Hence, miasmatic 
diseases scarcely ever prevail beyond the 56th degree of latitude ; because, 
though many days in summer may be very hot, the warm season is short. 
The nearer we approach the equator, the more abundant, virulent, and perni- 
cious does the poison become, wherever it is evolved, implying a greater 
intensity of the cause. Within the latitudes where there is a regular change 
of the seasons, they do not commonly make their appearance until the middle, 
and often not till the close of summer. 



4 



The development of this poison also requires a certain degree of moisture ; 
and the places which it usually infests, are most generally remarkable for 
their humid and swampy character. A large quantity of moisture, however, 
often serves as a preventive. During heavy rains, for example, their morbid 
effects are less felt than after the rains have ceased, and the water has run off 
from the surface of the country, or been partially evaporated. In tropical 
latitudes, it is after the cessation of the rains, that the ravages of the malarious 
fevers commence. 

In its medical sense, malaria is not simply bad or impure air, although the 
term is vaguely employed by many to express any mixed kind of contamina- 
tion of the atmosphere. In its production, vegetable decomposition has been 
mentioned among the requisites. That it is so, is inferred from numerous 
circumstances attendant upon the development of the morbific influence. In 
no situations is this so powerful as in deltas, and along the banks of large 
tropical streams, which in their period of flood, bring down the washings of 
the soil, loaded with vegetable remains, and, upon subsiding, leave them 
reeking in the hot sun. It is also peculiarly destructive when grounds covered 
with a luxuriant vegetation are overflowed, so as to destroy the plants, and 
occasion their putrefaction. Hence, miasmatic diseases are apt to follow the 
submerging of meadows in order to increase their fertility, the forming of 
niill-ponds, and damming of streams for the purposes of navigation. Neigh 
borhoods, before remarkably exempt from disease, have thus become very 
unhealthy, and have not ceased to be so until the vegetable matter thus 
deprived of its life, has undergone complete decomposition. The draining of 
lakes, ponds, &c., is often followed by disease ; because the organic matter, 
previously lying quiescent in their beds, is brought into a renewed move- 
ment of chemical re-action by exposure to the sun's heat. Hence, too, the 
increase of disease which often follows the commencement of cultivation, in a 
newly settled country, in consequence of the turning up of the soil, loaded 
with vegetable remains. If heat and moisture were alone adequate to pro- 
duce malaria, we should find the fever prevailing among sailors when out at 
sea ; but it is not so, whatever may be the temperature under which they 
cruise. It is when they approach the coast, or land upon it, that they are 
attacked. 

The emanations from the surface of the earth, which form the sole exciting 
cause of Intermittent and Remittent Fevers, are gaseous or aeriform, and are 
involved in the atmosphere ; but they are imperceptible by any of our senses, 
and we are made aware of their existence only by their noxious effect ; and 
the inference that they exist, was not made till within the last century and a 
half. It has, however, been a matter of common observation, that the inhabi- 
tants of wet and marshy situations were especially subject to these definite 
and unequivocal forms of disease. Lancisi, an Italian physician, was the first 
to put forth distinct ideas concerning the poisonous effects of malaria. The 
water of marshes has been examined under the microscope, and analyzed 
again and again, with a view to the discovery of the nature of this pestilential 
agent, but in vain. A more likely way to detect the noxious material, would 
seem to be by examining the air of malarious districts ; and this has been 
done carefully and repeatedly by expert chemists ; and with the same want 
of success. The poisonous principle eludes the test of the most delicate 
chemical agents. 

One of the most interesting circumstances in relation to misasmata is their 
apparent affinity for moisture. Water appears to have the property of dis- 
solving and retaining them, whether in a proper liquid state, or in that semi- 
liquid form in which it constitutes fogs and mists. 



5 



It is probably owing to this cause, that heavy and continued rains lessen 
the miasmatic influence. They wash the atmosphere clean of the noxious 
effluvia. Hence, too, the protective influence of floods and of deep water, 
which dissolve the miasm as it is generated, and prevent its escape by retain- 
ing it in solution. The greatest danger is after the waters have so far sub- 
sided, or been so far evaporated, as to be unable longer to dissolve the 
proceeds of the vegetable putrefaction. Persons on board of ships, and those 
on the sides of lakes opposite to the source of the exhalation, are much less 
exposed to disease than those at an equal distance by land, because the inter- 
vening water dissolves the miasmata in their passage. 

Malarious diseases are endemic along every part of the low and level coast 
of Holland. In Italy, the Pontine marshes near Rome, have possessed for 
ages an infamous celebrity of the same kind. The whole of the district called 
the Maremma, which extends along the shores of the Mediterranean from 
Livorno to Terracina, a distance of two hundred miles, with few interruptions, 
and reaches back to the base of the Appennines, in a varying breadth from 
ten to forty miles, is rendered dangerous, and almost uninhabitable, by the 
vast quantity of malaria annually evolved from its soil.* In our own country, 
large districts are, for the same reason, prolific of disease. 

The effects of this poison in all malarious districts are much more danger- 
ous at night than in the day-time. Whether the poison be then more copi- 
ously evolved, or whether it be merely condensed and concentrated by the 
diminished temperature, or whether the body be at that time more susceptible 
of its influence, it certainly is most active and pernicious during the hours of 
darkness. To sleep in the open air at night, in such places, is almost to ensure 
an attack of the fever. 

The miasmatic effluvium appears to rise by the heat of the sun, and to be so 
dispersed as to become innoxious, but to acquire a dangerous concentration 
by its union with the moisture, which forms the morning and evening dews„ 
Its tendency is to settle on the ground. Whether this results from its specific 
gravity, or from its adhering to the moisture suspended in the lower strata of 
the atmosphere, or from some peculiar attraction for the earth's surface is a 
matter of doubt. 

The morning and evening air is peculiarly injurious ; so much so that per- 
sons who go out of their houses only during the day, after the fogs have dis- 
persed in the morning, and before the dews descend in the evening, are apt to 
escape altogether.! Exposure, in the middle of the night is equally dangerous, 
and especially during sleep, when the power of resisting noxious agents is 

* The late Bisliop Heber, in his Narrative of a Journey through the Upper Provinces of India, 
gives the following striking picture of the influence of the malaria in that part of the "world. 16 
seems to be alike pestiferous to man and beast. 

" I asked Mr. Boulderson if it were true that the monkeys forsook these woods during the 
unwholesome months. He answered, that not the monkeys only, but every thing which has 
the breath of life, instinctively deserts them from the beginning of April to October. The 
tigers go up to the hills ; the antelopes and wild hogs make incursions into the cultivated plains ; 
and those persons — such as military officers — who are obliged to traverse the forests in the inter- 
vening months, agree that so much as a bird cannot be heard or seen in the frightful solitude. 
Yet, during the time of the heaviest rains, while the water falls in torrents, and the cloudy sky 
tends to prevent evaporation from the ground, the forest may be passed with tolerable safety. 
It is in the extreme heat, and immediately after the rains have ceased, in May, the latter end of Au- 
gust, and the early part of September, that it is most deadly. In October the animals return. 
By the latter end of that month the wood-cutters and the cow-men again venture, though cau- 
tiously. From the middle of November to March, troops pass and re-pass — and, with common 
precaution, no risk is usually apprehended." 

t Dr. Wood, of Philadelphia, says : 

" I was formerly the attending physician of a public institution, containing more than a hun- 
dred inmates, among whom, during the sickly seasons to which our vicinity was subject, 
autumnal fever was very prevalent, until the direction was given, and carried into effect, not to 
allow any one to go out before breakfast, or after tea." 



6 



diminished. Hence the peculiar danger of sleeping in tents, in sickly regions. 
It has been observed that persons in low grounds, are more exposed to sick- 
ness than those who live in elevated positions ; and instances have been 
recorded, in which lodgers upon the lower floor of a house have been attacked, 
while those upon the upper have escaped ; and experience is uniformly in 
favor of the proposition, that the poison is most prevalent and destructive 
near the surface of the earth, and does not rise high into the atmosphere. 

It has repeatedly been observed among the crews of ships, when off a ma- 
larious coast, that the sailors could go on shore through the day with impunity, 
while the men who remained on shore through the night, were many or all of 
them seized with the fever.* Those persons who, in summer, travel through 
the Pontine marshes, are admonished by Lancisi not to do so by night, as 
many had been accustomed to do, in order to avoid the great heat of the day : 
and similar advice is still given at Rome to all strangers. Though the passage 
requires but six or eight hours, there are numerous instances of travellers, 
who, in consequence of their having crossed the fens during the night, have 
been attacked with violent and mortal fevers. Brocchi, and several other 
writers, attribute the deadly influence of the malaria on the poor peasantry 
of the Roman Campagna to their defective clothing, and their want of fit 
shelter against the cold night winds, after the toil of a sultry day. 

McCullough is of opinion that the winds are capable of carrying miasmata, 
either enveloped in clouds and fogs, or otherwise, a very considerable distance, 
even so far as five or six miles. This may perhaps explain why it occasion- 
ally happens that a low district, where the miasmata are extricated, is less 
unwholesome than a neighboring elevation, towards which a prevalent wind 
blows over the surface of production ; and from the same cause, one side of 
a mountain may be very sickly, while the opposite side is remarkably healthy. 
The bank of a stream, in the direction of the ordinary winds, is sometimes 
more sickly than the opposite bank, though the latter may be nearer the spot 
where the cause originates. 

In this way we may sometimes account for the occurrence of disease in 
spots, which seem to offer none of the circumstances, ordinarily considered 
essential to the production of malaria. 

In what manner miasmata operate in producing disease cannot be known 
until we know their nature. The probability is, that they enter the circu- 
lation by means of absorption, and that the chief avenue through which they 
enter is the air-cells of the lungs. It is not impossible that they may also be 
absorbed through the skin, and even through the mucous coat of the stomach, 
which they may enter with the saliva. A full meal, and the stimulant influ- 
ence of ardent spirit, are supposed to afford some protection against them. 
Absorption is probably impeded by these means, and thus far, they act as 
preventives of the malarious influences ; but just in proportion to the protec- 
tion which ardent spirit or other stimulant may yield, during the period of 
excitement, will be the greater liability to attack, when excitement shall be 
succeeded by depression. 

* It is recorded by Dr. Lind, "that in 1766, the British ship-of-war Phoenix was returning 
from the Coast of Guinea. The officers and ship's company were perfectly healthy till they 
touched at the Island of St. Thomas. Here nearly all of them went on shore. Sixteen of the 
number remained for several ni-ghts on the island. ' Every one of these contracted the disorder, 
and thirteen of the sixteen died. The rest of the crew, consisting of two hundred and eighty 
men, went in parties of twenty or thirty on shore in the day, and rambled about the island, 
hunting, shooting, and so on : but they returned to the ship at night ; and not one of those 
who so returned," suffered the slightest indisposition. Exactly similar events occurred the fol- 
lowing year, with the same ship, at the same place, where she lost eight men out of ten, who 
had imprudently remained all the niglxt on shore; while the rest of trie ship's company, who, 
after spending the greatest part of the day on shore, always returned to their vessel before night; 
continued in perfect health. ' 



7 



The most striking and characteristic morbid effects of miasmata, are inter- 
mittent and remittent bilious fevers ; but they are believed to be capable of 
producing diarrhoea, cholera, colic, dysentery, diseases of the liver and kid- 
neys, gastric derangements, neuralgia, &c. 

The biliary functions suffer the most, so much so, that in some countries 
the disease is known under the name of the Gall Fever. The frequent con- 
centration of the blood in the internal parts may afford a reasonable explana- 
tion of these phenomena. 

Inhabitants of malarious districts are apt, even when laboring under no 
well-marked and definite complaint, to exhibit signs of feeble health, in their 
spare habit of body, sallowness of complexion, uncertain appetite, and irre- 
gular bowels ; and persons are not unfrequently found with enlarged spleen 
or liver, swelled abdomen, and even dropsical symptoms. 

The spleen is sometimes so enormously increased in bulk, as to he felt, and 
even its outlines seen through the integuments of the abdomen. It has been 
known to weigh nearly eleven pounds ! So common is this state of the spleen, 
that it is usually called Ague Cake. "Whenever the abdominal circulation is 
much embarrassed, and the abdominal veins gorged — as they must be during 
the cold stage of an Intermittent — the spleen in particular becomes distended 
with blood. This happens constantly when the passage of the blood through 
the portal vessels is impeded by diseases of the liver. This distention does 
not probably subside at once. If the paroxysms of Ague be frequently 
repeated, we may understand how the spleen may become fuller of blood on 
each successive occasion. It may be that a portion of the blood coagulates, 
or that inflammation of a slow kind is set up in the stretched covering of that 
organ. At all events, this is a very common sequel of Ague ; and it cannot 
be doubted that the repeated congestions of the internal vessels are the deter- 
mining causes of the Ague Cake. 

Diseases, usually the result of miasmata, sometimes occur epidemically, 
with all the characters of the cases that are obviously of local origin. Whe- 
ther, in such instances-, the cause may be the same as that of the identical 
endemic affections, it is impossible to determine ; for the circumstances in 
relation to temperature, atmospheric moisture, and the character of vegeta- 
tion, in the different seasons during which the epidemic has prevailed, have 
been so variable, that no tolerably certain inference can be deduced from them. 
From the fact, however, that the disease usually appears at the same season, 
as well as from their identity of nature, there seems to be good reason for 
ascribing them to the same malarious influence. But the peculiar condition 
of things which causes the development of this influence over wide regions 
where it had been before but little known, remains quite concealed. 

The poisonous effects of malaria upon the liver are such as to render this 
important organ almost inactive. The hepatic ducts become obstructed, and 
the bile that is secreted is re-absorbed into the blood, and carried into every 
part of the system, instead of passing into the bowels, and producing its 
natural purgative effect. 

In hot climates, the liver and its appendages are kept in an undue state of 
excitement, both from the direct stimulant influence of heat upon that organ, 
and from the additional duty which it has to perform, in the elimination of 
carbonaceous matter. A certain excess of carbon is introduced with the food, 
which is thrown off partly by the lungs and skin, in the form of carbonic acid, 
and partly by the liver in the form of fatty matter. That part of it which is 
converted into carbonic acid, answers the additional purpose of affording 
animal heat ; but, as little of this is needed in hot countries, there is less of 
the acid formed, and a greater proportion of carbon must consequently escape 



8 



by the liver. Hence is established a predisposition to biliary and gastro* 
intestinal diseases. 

The stomach and kidneys are among those organs which are sensibly affected 
by this wide-spread poison ; and it is not strange that when these important 
organs cease to perform the duty which nature has assigned to them, that the 
result should be a general derangement of the whole system. 

Neuralgia, periodical Headache, and Tic Doloureux, are modified forms of 
Intermittent Fever, and are produced from the same cause as Ague — viz., the 
miasm of marshes, or malaria, which mysteriously exerts its primary or chief 
influence apparently upon the nervous system. 

Wherever the malaria prevails, it produces its peculiar consequences chiefly 
in certain seasons ; and it is in the autumn especially that agues and aguish 
fevers occur ; and the hotter and drier the preceding summer, the more 
frequent and fatal are the autumnal fevers. Agues may, however, attack a 
person at any time ; but they are much more common in spring and in autumn 
than in the other seasons of the year. Yet it is one of those disorders to 
which all persons, at all periods of their existence, seem to be susceptible 
when exposed to the influence of the exciting cause. 

Each paroxysm of an Intermittent Fever, when quite regular and fully 
formed, is composed of three distinct stages ; and they are severally named, 
from the phenomena that characterizes them, the cold, the hot, and the sweat- 
ing stages. 

The attacks of this disease usually return with great regularity, and have 
in consequence been distinguished by names having reference to the periods 
of their visits. From this characteristic they have been divided into the 
Quotidian, returning after a lapse of twenty-four hours ; the Tertian, return- 
ing after a lapse of forty-eight hours; and the Quartan, returning after a 
lapse of seventy-two hours ; and so on until the interval extends to nine or 
ten days. 

A person who is on the brink of a paroxysm of Ague, experiences a sensa- 
tion of debility ; he becomes weak, languid, listless, and unable to make any 
bodily or mental exertion. He begins to sigh, and yawn, and stretch him- 
self ; and he soon feels chilly, particularly in the back, along the course of the 
spine ; the blood deserts the superficial capillaries ; he grows pale ; his fea- 
tures shrink ; and his skin is rendered dry and rough, drawn up into little 
prominences, such as may at any time be produced by exposure to external 
cold. Presently the slight and fleeting sensation of cold, first felt creeping 
along the back, becomes more decided and more general ; the patient feels 
very cold, and he acts and looks just as a man does who is exposed to intense 
cold, and subdued by it ; he trembles and shivers all over ; his teeth chatter ; 
his hair bristles slightly from the constricted state of the integuments of the 
scalp ; his face, lips, ears, and nails, turn blue ; his respiration is quick and 
anxious ; his pulse frequent sometimes, but feeble ; and he complains of pains 
in the head, back, and loins; all the secretions are usually diminished; his 
bowels are confined, and his tongue is dry and white. 

After this state of general distress has lasted for a certain time, it is suc- 
ceeded by another of quite an opposite kind. The cold shivering begins to 
alternate with flushes of heat, which usually commence about the face and 
neck. By degrees the coldness ceases entirely — the skin recovers it natural 
color and smoothness — the collapsed features and shrunken extremities resume 
their ordinary condition and bulk. But the reaction does not stop here ; it 
goes beyond the healthy line. The face becomes red and turgid — the general 
surface hot, pungent, and dry — the temples throb — a new kind of headache 
is induced — the pulse becomes full and strong, as well as rapid — the breathing 



9 



is again deep, but oppressed — the urine is scanty but high-colored — the patient 
is exceedingly uncomfortable and restless, At length another change comes 
over him : the skin, which, from being pale and rough had become hot and 
level, but harsh, now recovers its natural softness ; a moisture appears on the 
forehead and face ; presently a copious and universal sweat breaks forth, with 
great relief to the feelings of the patient ; the thirst ceases ; the tongue 
becomes moist ; the urine plentiful but turbid ; the pulse regains its natural 
force and frequency ; the pains depart ; and by and by the sweating also ter- 
minates, and the patient is again nearly as well as ever. This is certainly a 
very remarkable sequence of phenomena: and it would appear still more 
remarkable if it were less familiar to us. The earlier symptoms are all indi- 
cative of debility, and of a depressed state of the nervous system. There is 
the same sensation of exhaustion, with incapacity of exertion, which is pro- 
duced by fatigue. The sighing, yawning, and stretching, all indicate debility. 
The paleness of the surface, and constriction of the skin, and collapse of 
the features, are all owing to the retirement of the blood from the superficial 
capillaries. 

The skin shrinks, but the parts containing the bulbs of the hair cannot con- 
tract so much as the other parts, and therefore the surface becomes rough, and 
the hairs bristle up. The coldness of the skin is another consequence of the 
emptiness of its blood-vessels ; and the tremors, which are always indicative 
of debility, seem to depend upon the coldness. The necessary accumulation 
of blood in the larger and internal vessels, offers a reasonable explanation of 
the distressed and anxious breathing. 

Some writers have spoken of the hot stage, as though it were a necessary 
consequence of the cold. But if the cold fit be in any sense or degree the 
cause of the hot fit, it can only be so partially. The cold stage may occur 
and never be followed by the hot ; or the hot stage may come on without any 
previous cold stage ; and when they do both happen, they are not by any 
means proportioned to each other. When we thus see that a supposed cause 
is not always followed by the effect, and that the effect is sometimes produced 
without the agency of the supposed cause, and also that the supposed cause 
and the effect are not proportioned to each other, we cannot but conclude that 
the supposed cause is at most but a partial and accessory cause. We can 
more easily conceive how the hot fit may conduce to bring on the sweating 
stage. 

The stronger action of the heart, and the more forcible propulsion of the 
blood, will fill the superficial vessels, and in this way the natural secretions 
may be restored. We see exactly the same thing happen when the force of 
the circulation is increased by exercise : the extreme vessels receive a larger 
supply of blood, and sweat ensues. 

The period which elapses between the termination of one paroxysm of Ague 
and the commencement of the next, is called an intermission ; while the period 
that intervenes between the beginning of one paroxysm and. the beginning of 
the next, is called an interval. As the paroxysms are liable to vary in length, 
the intermissions may be very unequal, even when the intervals are the same. 
When the intermissions are perfect and complete, the patient resuming the 
appearance and sensations of health, the disorder is an intermittent fever. 
When the intermissions are imperfect, the patient remaining ill, and feverish, 
and uncomfortable, in a less degree than during the paroxysm, then the com- 
plaint is said to be a remittent fever. 

Sometimes the paroxysm is incomplete ; it is shorn of one or more of its 
stages : the heat and sweating occur without any previous rigors ; or the 
patient shakes, but has no subsequent heat, or the sweating stage is the only 



10 



one of the three that manifests itself. These fragments of a fit are often 
noticeable when the complaint is about taking its departure ; but they may 
also occur at other periods of the disease. Sometimes there is no distinct 
stage at all; but the patient experiences frequent and irregular chills, is 
languid, uneasy, and depressed. This state is generally known as the dumb 
Ague. 

Intermittent Fever, being the mildest form of miasmatic fever, is that which 
ordinarily occurs in situations, and at periods, when the miasmatic influence 
is least intense, and in persons who, from habit or any other cause, are least- 
susceptible to injury from it. Though this particular cause may be essential, 
yet there are others which very much assist its action. The poison seems to 
find a more ready entrance into the system, when exhausted by fatigue or 
hunger, debilitated by previous disease or mental depression, and during 
sleep. It often lurks in the system without obvious effect, for a longer or 
shorter period of time, causing rather a predisposition to the disease than the 
disease itself. Under these circumstances, any exciting cause may call the 
fever into action ; and sometimes an attack is produced which might have 
otherwise been avoided. Exposure to the heat of the sun, a cold bath, exces- 
sive exertion, or mental excitement, may give rise to a paroxysm. The con- 
trast between the cold of the mornings and evenings, and the heat of the 
middle of the day, favors the development of the disease in the latter part of 
summer, and the beginning of autumn. 

Among all the circumstances which predisposes to fever and ague, debility, 
no matter how produced, has a powerful influence.* But the strongest pre- 
disposing cause of all is an actual occurrence of the disease itself. The effect 
of former attacks upon the system is such that the complaint may be repro- 
duced by agencies which, under any other circumstances, would be quite 
inoperative. The disease leaves the system in a condition, in which injurious 
influences, other than malaria, may of themselves be sufficient to renew it. 
It brings into play a new order of exciting, or rather, of re-exciting causes. If a 
person were never exposed to the poisonous effects of malaria, he would never 
have an attack of intermittent fever ; but having once had it, he may many 
times have it again, although he should never again be subjected to the direct 
influence of malaria. 

Remittent or bilious fever occurs more or less in all parts of the United 
States, lying between the Northern Lakes and the Gulf of Mexico, and on 
the shores of the Pacific, but is much more frequent in the middle and south- 
ern sections than in the northern. It is rare in the mountainous and hillv 
districts of our country, except where there are large streams or standing 
water. The situations in which the disease is most prevalent are the valleys 
of streams, the borders of lakes or ponds, the neighborhoods of marshes, 
and the rich prairies of our Western States. It is in general a much more 
serious disease in the southern and south-western sections of the United States, 
than in those portions of the north which are still within the limits of its pre- 
valence. But the disease is not confined to our own country. It is endemic 
almost everywhere in hot climates, and especially where heat, moisture, and 
decaying vegetable matter act conjointly. Comparatively mild in temperate 
latitudes, it becomes extremely fatal in many places within the tropics. It is 
the disease which has raged so fearfully in the East Indies, Africa, the Medi- 
terranean, and South America, and which has depopulated the Campagna of 

* Dr. Thomas "Watson, in one of his lectures, states that " soldiers in the British Army have 
been exposed to the exciting cause, without becoming affected by it while strong and in good 
health, and have fallen ill of Intermittent Fever upon being weakened by exertion and 
fetigue. 1 ' 



11 



Rome, and rendered intertropical Africa uninhabitable by whites. It has 
frequently received names from the localities where it prevails. Thus we hear 
of the A frican fever, the Bengal fever, the Walcheren fever, the Chagres, and 
the Panama fever, dbc. Under whatever name the disease is known, it is essen- 
tially the same, varying only in its intensity, and is produced from the same 
miasmal cause. 

The manner in which the noxious effluvia, called miasmata or malaria, is 
produced, and its effect upon the human system, has been stated in the fore- 
going, as well as the symptoms which indicate a near approach of Intermittent 
Fever, or as it is commonly called, Fever and Ague. As this is the most 
common form of bilious disease, it requires our particular attention. The 
mode usually adopted of treating it, has been invariably with tonics, adminis- 
tered for the purpose of breaking the chill while nothing is done to counteract 
the effect of the malaria and remove the disease. It should be borne in mind, 
that simply breaking the chill, is very far from effecting a cure ; the disease 
is only suspended, and again returns upon exposure to any of those causes 
which favor its reproduction. 

The Lexipyreta has been prepared (after a thorough knowledge of the path- 
ological character of the disease.) with particular reference to the permanent 
removal and cure of the disease ; and the success which it has met with in 
the treatment of Fever and Ague, proves it to be what its name indicates — a 
medicine, possessing the power to abate, or drive away a fever. Its effect 
upon the human system is to purify the blood,* (which is greatly altered in 
all malarious diseases,) — promote the discharge of bile — remove obstructions 
of the liver, and excite all the diseased organs to a healthy action. It is a 
powerful deobstruent medicine, designed particularly to counteract the baneful 
effects of malaria upon the human body. For the prevention of Fever and 
Ague, it will be found no less effectual, as well as for the cure of all other 
Bilious Diseases, Jaundice, Liver complaint, Indigestion, Dyspepsia, ckc. 

Relapses are very frequent in cases of Intermittent Fever, and give the 
unfortunate sufferer much trouble. By ascertaining the period at which the 
disease is disposed to return, which is remarkably regular in each case, the 
recurrence may almost always be prevented, and the disease finally eradicated, 
by a timely and persevering use of the Lexipyreta. The importance, there- 
fore, of having the Remedy at hand must be obvious to all. It is a vegetable 
preparation, and contains no mineral substance whatever. 

Persons travelling through infected districts, either S<?uth or West, will find 
it a sure preventive : and to emigrants from healthy localities it will prove 
invaluable ; by using it during the sickly season, they need apprehend but 
little danger. 

The Lexipyreta is not designed to cure every disease incident to the hu- 
man frame, yet it is confidently believed lAat a timely resort to this remedy 
would be the means of saving "the lives of a large portion of those who are 
yearly numbered among the victims of bilious diseases. 

With the medical profession, the able works of Doctors Wood and Watson, 
on the practice of medicine, are justly regarded as among the most valuable 
contributions to medical science ; and in the compilation of this pamphlet, 
these, and other works of acknowledged reputation have been freely drawn 
upon, consequently, nothing is advanced which is not sustained by medical 
authority of the highest respectability. 

In offering the Lexipyreta to the notice of a discerning public, the proprietor 
simply remarks that he does so, relying only upon its intrinsic merits, to com- 
mend it to popular favor. 

* Dr. Stevens asserts that the "blood is altered essentially in character by the miasmatic cause 
of bilious fevers, and evinces this change for days or even weeks before the fever appears. 



12 



DIRECTIONS. 

Should the patient, at the time of commencing the use of the Lexipyreta, 
be suffering from Fever and Ague, Dumb Ague, Chill Fever, or Intermittent 
Fever in any form, it will be necessary to take it four times a day, and so 
continue the use of it until the periodical return of the disease is arrested, 
which is most generally accomplished after taking ten or twelve doses ; so 
prompt is it in its action, that many times the patient experiences no trouble 
or inconvenience after taking it two or three times. The best time for taking 
it is about a quarter of an hour before the usual time of meals, and on going 
to bed. 

After the disease ceases to return periodically, the remedy should be taken 
only three times a day, morning, noon, and night, until a complete and per 
manent cure is effected. 

If the patient is costive, a dose of some kind of cathartic pills, or two or 
three five grain blue pills, should be taken. In most cases, however, the 
Lexipyreta will be found to have a sufficient purgative effect ; in cases where 
it does not, the patient should take some laxative medicine every other night 
on going to bed. 

The diet, during the continuance of the disease, should be light, digestible, 
nutritious, and unstimulating. For the first day or two, animal food should 
generally be avoided, and afterwards the lighter kinds should be used, such 
as milk, soft boiled eggs, and boiled meats, in connexion with farinaceous sub- 
stances, and easily digested vegetables. Stimulating drinks should not be 
used ; and the patient should always avoid eating a full meal, within two or 
three hours of the expected paroxysm, as the food does not digest during the 
fever, and sometimes serves as a source of injurious irritation. 

It requires a much longer time to effect a cure in those cases where the 
patient has been for a long time suffering from the disease, or been for a long 
time subject to the pfimary exciting cause. It will, therefore, be necessary in 
such cases to take the Lexipyreta for several weeks to insure a perfect cure. 
In all cases, the medicine should be taken regularly, as directed ; by so doing, 
its effects will be more certain and require less time to eradicate the disease 
from the system. 

For enlargement of the Spleen, or Ague Cake, it should be taken three 
times a day, and continued for two ox three months in all cases which have 
been of long standing ; by adopting this course, the patient will almost inva- 
riably experience the happy influence of the laedicine, and this organ become 
reduced to its natural size. 

For Remittent Fever, it should be taken three times a day, and continued 
until the health is restored. 

For the cure of Jaundice, Liver Complaint, Indigestion, Dyspepsia, &c., it 
will be found equally effectual, taken in the usual doses. 

Persons travelling in malarious sections of country, will find the medicine 



IS 



to be an effectual preventive against Fever and Ague, if taken three times 
a day. 

Should the medicine, in cases where the patient is of a weakly constitution, 
prove too laxative, the dose should be lessened until it has the desired effect. 

The dose for a grown person is two teaspoonsful, taken in a small quantity 
of water ; children from six to twelve years of age, one ieaspoonful ; from 
three to six years, forty drops ; from one to three years, twenty-five drops ; 
under one year, from ten to fifteen drops. 

As before remarked, the Lexipyreta is entirely a vegetable preparation, and 
may be administered under all circumstances, with perfect safety, to either 
young or old. 

The bottle should toe kept well corked, and thoroughly shaken before 
each dose. 



TESTIMONIALS 



EN" FAVOR OF THE EXTRAORDINARY VIRTUES OF 



IN THE TREATMENT AND CURE OF 

Fever and Ague, Chill Fever, Intermittent and Remittent Fevers, Dumb Ague, 
Jaundice, Liver Complaint, Enlargement of the Spleen and lAver, 
and all the various forms of Bilious Diseases, incident to the 
Southern and Western States. 



Among the many testimonials which have been received in favor of the 
extraordinary virtues of the Lexipyreta, the following only are selected : 

From Mr. J. W. Woodmansee, of Rosendale, New York, addressed to the pro- 

prietor, dated 
San Francisco, California, Sept. 16th, 1849. 

Dear Sir — It is with great pleasure that I recommend your Lexipyreta as a 
safe and effectual remedy for Fever and Ague. 

I left Sacramento City on the 14th of August last, and arrived at this place 
on the 6th inst. During the time that I was making the passage, I was ex- 
posed to the influence of the malaria which is so abundant at different points 
on the river, and on reaching this place, was completely unfit for labor, having 
been afflicted with Fever arid Ague for several days. I immediately com- 
menced taking the Lexipyreta according to directions, and in two days was 
completely cured. I cannot too strongly recommend it to those afflicted with 
Fever and Ague as a safe and sure remedy for this distressing complaint. No 
one should think of going to the mines without being provided with this 
invaluable remedy. J. S. Woodmansee. 

From Clinton Colton, Esq., of New York, to the proprietor, under date of 

San Francisco, Sept. 18th, 1849. 
Dear Sir — I have used your Lexipyreta with the happiest effect for the 
cure of Kemittent Fever and Fever and Ague. I have also seen it used by 
others, and in all cases it has given the most perfect satisfaction. I do not 
hesitate to recommend it to those afflicted with Fever and Ague, or any form 
of Bilious Fever, as a safe and sure remedy. 

Clinton Colton. 



15 



Copy of a letter from Mr. Charles Gates, of Worcester, Mass., dated 

San Francisco, Cal., January 4th, 1850. 
Dear Sir — While laboring at Benicia some three months ago, I was attacked 
with that most distressing and unpleasant disease called Fever and Ague. A 
friend of mine, who had only a few days before been cured of the same 
disease by the use of your Lexipyreta, had a part of a bottle left, which he 
presented to me, remarking at the same time that it would cure me. I com- 
menced taking it according to directions, and sure enough in a few days I was 
completely cured. Since that time I have been exposed to the miasmal influ- 
ences so abundant here, and about two weeks since was again attacked with 
this disagreeable complaint. I immediately procured a bottle of the Lexipy- 
reta, and commenced taking it, and I am gratified in being able to inform you 
that I did not experience a chill after taking the first dose. My general health 
has very much improved since I commenced using the remedy, and I am free 
to say that I have not enjoyed so good health since I have been in the country 
(a period of five months), as I enjoy at this moment. I cannot be too grate- 
ful for the relief which I have thus received at your hands, and I cheerfully 
add my testimony in its favor, advising all who are afflicted with Fever and 
Ague to give it a trial. Yours, respectfully, 

Charles Gates. 



From Capt. George Eldridg-e, of Mystic, Conn. 

San Francisco, Dec. 24th, 1849. 

To John L. Devotion : — 

Dear Sir — Having experienced the good effects of your Lexipyreta, I 
take great pleasure in recommending it to those afflicted with Fever and Ague, 
Dumb Ague, &c, as a safe and effectual remedy. Its action in my case was 
of the most satisfactory character. For the last six months I have navigated 
the Eiver Sacramento, and during this time I have had numerous opportuni- 
ties of witnessing its beneficial effects when administered to others, and I have 
not heard of a single instance where it has failed to cure. 

I believe it to be a most valuable medicine for the diseases for which it 
is recommended, and one in which the public may place the utmost confidence. 

Kespectfully yours, George Eldridge. 



Extract of a letter from Mrs. Mathews, of St. Joseph's County, Michigan, 
addressed to the proprietor, dated February, 20th, 1850. 

She says : — I think, when the Lexipyreta is thoroughly introduced and 
known as a cure for Fever and Ague, that it will stand unrivalled as a sove- 
reign remedy. 1 made use of it in our family last summer, as it was an 
unusual time for the Ague, and it proved effectual in every case. My husband 
was attacked very severely, but the Lexipyreta cured him in a few days. In 
short, I must say that I have such an exalted opinion of this medicine, that I 
should never be willing to be without it. 



From Mr. Thomas Gates, of Worcester, Mass., dated 

San Francisco, January 30th, 1850. 
Dear Sir — Having experienced the good effects of your Lexipyreta in the 
cure of Fever and Ague, I can most cheerfully add my testimony in favor of 



LIBRARY OF CONGRESS 



its sanative powers. I was attacked with this unpleasant complaint while a% 
the mines in September last, and being unable to procure anything to check 
the progress of the disease, I was obliged to leave. On my arrival at Sacra- 
mento City I was fortunate enough to procure a bottle of your valuable medi- 
cine, and after taking a few doses was completely cured. I can with confidence 
recommend it to those afflicted with Fever and Ague, as a safe. sure, and 
effectual remedy. Yours truly, 

Thomas Gates. 



i6 021 623 835 7 



Mr. Samuel Adams, a highly respectable Druggist of San Francisco, in a 
letter addressed to the proprietor, under date of August 30th, 1850, writes as 
follows: — "Your Lexipyreta sustains its character, and sells without any 
effort of mine, when one bottle goes, several others are seen to follow in its 
wake. It works its own way along." 



From the Sacramento Transcript of April 3c?, 1850, published at Sacramento 

City, California. 

The attention of our readers is directed to an advertisement in another part 
of the paper, headed " Fever and Ague." Persons suffering from this dis- 
tressing complaint, will find that " Devotion's Lexipyreta" it no humbug, and 
that it will perform a speedy cure in all cases. We have seen the article 
administered several times with the happiest effects, and do not hesitate to 
recommend it as a valuable medicine. 



LIBRARY OF CONGRESS 











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pH 8.5 



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